Transcript 16.AbnormalityTherap..

Abnormality, Therapy,
and Social Issues
What is “abnormal”?
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If we say that abnormal is any behavior significantly
different from the average…
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If we say that abnormal is any emotion significantly different
from the average….
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Aren’t there some undesirable but normal behaviors?
If we say that abnormal is when people feel like they are
distressed…
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We all have strange thoughts from time to time?
If we say that abnormal is anything that is undesirable…
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Don’t we all feel sad, anxious, angry occasionally?
Extremely happy people would be considered mentally ill?
If we say that abnormal is any thought significantly different
from the average…
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Then what about the effect of life stressors or situations?
Then what happens when “average” changes over time?
What about positive (but non-normal) behaviors?
What about people who think they have a problem, but actually don’t?
What about people who don’t have a problem, but believes they do?
If we say that abnormal is based upon the cultural rules…
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Each era and society has had its own interpretations of abnormal behavior?
Classifying Psychological
Disorders
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The DSM-IV - Diagnostic and Statistical
Manual of Mental Disorders
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This manual has been created to establish uniform
definitions and standards for diagnosis.
It lists acceptable labels for all psychological
disorders.
It lists symptoms and criteria for making diagnoses
and contains information on differential diagnosis –
how to distinguish a particular disorder from others
that are similar to it.
Classifying Psychological
Disorders
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The DSM-IV - Clinical disorders = Axis I.
Classifying Psychological
Disorders
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The DSM-IV – Personality Disorders = Axis II
Classifying Psychological
Disorders
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The DSM-IV
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Axis III is for general medical conditions that
may influence the person’s mood or behavior.
Axis IV is for psychosocial and environmental
problems that may increase the person’s level of
stress.
Axis V is a 1-90 scale called the global
assessment of functioning. The lower the
number assigned by the assessing clinician, the
less likely it is that the person being diagnosed is
able to function without treatment and support.
According to one extensive survey, about half the people in the
United States will suffer at least one psychological disorder at some
time.
Psychotherapy
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Psychotherapy is a treatment of psychological
disorders by methods that include an ongoing
relationship between a trained therapist and a client.
Psychotherapy is provided by…
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Clinical psychologists
Counseling psychologists
Psychiatrists
Clinical social workers
Psychiatric nurses
Counselors
There are many techniques of psychotherapy, but all
of them seem to depend in large part on the client’s
motivation to improve.
Schools of Psychotherapy
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(1) Psychoanalysis
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Psychoanalysis is the oldest “talk” therapy. It attempts
to bring unconscious thoughts and emotions to
awareness, and help people understand their own
thoughts and actions.
Schools of Psychotherapy
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(2) Behavior therapy
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Behaviorists believe that human behavior is learned
and can be unlearned.
Uses learning theories like classical conditioning and
operant conditioning, such as systematic
desensitization and aversion therapy
Schools of Psychotherapy
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(3) Cognitive Therapy
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These are therapies that focus on thoughts and
beliefs, and seek to improve people’s functioning by
changing how they think and interpret events
Schools of Psychotherapy
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(4) Humanistic therapy
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The source of psychological distress is perceived
incongruence between the way an individual’s selfconcept and his or her ideal image of self.
The therapist tries to be genuine, empathetic and
caring, and tries not to interpret the client’s thoughts or
feelings or offer advice.
Schools of Psychotherapy
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(5) Psychopharmacotherapy
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Antianxiety - Valium, Xanax, Buspar
Antipsychotic - Thorazine, Mellaril, Haldol
Antidepressant - Elavil, Tofranil, Prozac, Paxil, Zoloft
Mood stabilizers – Lithium, Valproic acid
Psychotherapy
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How effective is psychotherapy?
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Meta-analysis of many studies of psychotherapy suggests that
a majority of people do show improvements after therapy.
No one method of therapy stands out as better than the
others.
Why is it effective?
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Because of the treatment?
Because of the relationship with the therapist? Social support?
Because of encouragement on regular basis?
Because client engages in self-examination?
Because reinforcing client’s desire to change and improve.
Psychotherapy
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How to choose a therapist?
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No one way of doing psychotherapy is right for every
client. You need to use your knowledge to “shop” for
the therapist who will work best with you.
As with any other “remedy” be skeptical of
overconfidence and claims of amazing results.
Expect at least some small improvement within a
couple of months of starting, and don’t be afraid to ask
for your therapist’s input if this doesn’t happen.
Be an active participant in your own treatment –
nobody “fixes” you, rather, you receive help in
changing your own life.
What is self-help?
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Self help = any instance where an
individual or a group attempts self-guided
improvement, typically through publicly
available information.
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Books
Audio
cassettes
DVDs
Video DVDs
Internet
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Motivational speakers
Seminars
Programs
Personal coaching
Support groups
How extensive is self-help
information?
 Billions!
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Ingrained into culture
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“Twelve step program”
Self-help books -- “Dummies” Guide
“self help psychology” returned over 12million+
hits on Google
Why is it so extensive? (benefits)
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Within therapy
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Therapist uses to give client more information
More information “out-of-office”
Client uses for day-to-day continuing education
Beyond therapy
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Can provide help that therapy can not
Experiential knowledge from more experts
Experiential knowledge from people going through
the same thing (support group)
Support groups also provide sense of belonging,
friendship, identity, peer-to-peer support
Criticisms of self-help? (risks)
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Without therapist, no trained professional so…
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Improper assessment
Inappropriate treatments
Failure may make it worse
Without scientific data to confirm validity, then..
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possibly misleading and inaccurate
potentially harmful and dangerous
pseudo-scientific assertions
offering "easy answers" to difficult personal problems
Do
the risks
outweigh the
benefits?